Figure 1. TSH, T4 and T3 level from diagnosis throughout various
thyroxin treatment doses till 2020.
Given the values of high TSH not suppressed by levothyroxine treatment,
we started to think about alternative diagnosis that leads to persistent
elevation of TSH for example TSH secreting tumor and TSH resistance.
Magnetic Resonance Images (MRI) of the pituitary gland was ordered to
exclude TSH secreting pituitary tumor which revealed normal pituitary
gland size. See figure 2.